Cherry Lane Family Clinic, PA

NPI #1962554063 in Meridian, Idaho

Provider Information

NPI Number: 1962554063
Entity Type: Organization
Organization Name: Cherry Lane Family Clinic, PA
Primary Specialty: Family Medicine
Enumeration Date: Jan 17, 2007
Last Updated: Sep 14, 2010

Practice Location

Address: 1001 N MERIDIAN RD
City: Meridian
State: Idaho
ZIP Code: 83642-1610
Phone: (208) 884-4800

Authorized Official

Name: TIMOTHY MCHUGH, M.D.
Title: OWNER
Phone: (208) 884-4800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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